消覃汤加减预防大肠息肉摘除术后(脾虚夹瘀证)息肉再发的回顾性研究

Retrospective study of modified Xiaotan Decoction in the prevention of polyp recurrence after colorectal polypectomy( spleen deficiency with blood stasis syndrome)

目的评价消覃汤加减对大肠息肉摘除(脾虚夹瘀证)1年后息肉再发的预防效果。方法选择大肠息肉摘除术患者149例,均病史资料完整、中医辨证为脾虚夹瘀证且术后1年复查肠镜;其中规范服用消覃汤1年者(治疗组)79例,未服任何药物者(非治疗组)70例。比较两组大肠息肉摘除1年后的再发及中医证候情况。结果 1大肠息肉摘除1年后,治疗组再发率为18.99%(15例),低于非治疗组的38.57%(27例)(P<0.05);其中治疗组腺瘤性大肠息肉、非腺瘤性息肉再发率分别为20.75%、15.38%,非治疗组分别为42.86%、32.14%,组间腺瘤性息肉再发率差异有统计学意义(P<0.05)。2治疗组除畏寒怕冷无明显改善外(P>0.05),其余各单项证候均有改善(P<0.05)。结论消覃汤加减对大肠息肉摘除术后(脾虚夹瘀证)的息肉再发有一定防治作用,且能在一定程度上改善患者的中医证候。

Objective To evaluate the effects of modified Xiaotan Decoction in the prevention of polyp recurrence one year after colorectal polypectomy（ spleen deficiency with blood stasis syndrome）. Methods There were 149 patients of colorectal polypectomy with complete medical data,who were identified as spleen deficiency with blood stasis syndrome in Chinese medicine and reviewed by colonoscopy one year after operation. Among,79 cases who had regularly taken Xiaotan Decoction for one year were divided into the treatment group,and 70 cases who had not taken any drugs were divided into the non-treatment group. The recurrence one year after colorectal polypectomy and the traditional Chinese medicine（ TCM） syndrome in both groups were compared. Results 1 One year after colorectal polypectomy,the recurrence rate in the treatment group was 18. 99%（ 15 cases）,which was lower than 38. 57% in the non-treatment group（ 27 cases）（ P〈 0. 05）. Among,the recurrence rate of adenomatous colorectal polyps and non-adenomatous polyps was 20. 75% and 15. 38% in the treatment group and 42. 86%and 32. 14% in the non-treatment group respectively,there was statistically significant difference on the recurrence rate of adenomatous polyps between the two groups（ P 〈0. 05）. 2 The obvious change of fear of cold in the treatment was not found（ P 〈0. 05）,but other single syndrome were all improved in the treatment group（ P〉 0. 05）. Conclusion The modified Xiaotan Decoction shows certain effects in the prevention of polyp recurrence after colorectal polypectomy（ spleen deficiency with blood stasis syndrome）,and improves the TCM syndrome of patients to some extent.